Biomedical subjects
Publications and source records attributed to U H Lewinski.
Urinary tract infections have been treated empirically according to the development of bacterial resistance, and semisynthetic penicillins have been out of favor. Only 12% (4/34) of our patients treated with augmentin failed to respond, compared with 20% of those on a combination of gentamicin and ampicillin.
Sarcoidosis is an uncommon disease with many types of presentation. A 32-year-old woman is described in whom subcutaneous nodules were the presenting symptom. This presentation is vary rare; the differential diagnosis includes rheumatic fever, rheumatoid arthritis, systemic lupus erythematosus and fungal infections.
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A Jewish Iraqi woman with familial isolated renal tubular uricosuria, urate clearance of 60.5 +/- 5.7 ml/min and hypouricemia of 1.0 +/- 0.2 mg/dl is described. The combined pyrazinamide-probenecid test suggested a presecretory defect in urate reabsorption. Four offspring were moderately affected. This family represents the sixth Jewish Iraqi family with familial isolated presecretory uricosuria, and emphasizes the marked prevalence of this disease among the Iraqi Jewish population. Since the inheritance of the presecretory defect is autosomal recessive, we suggest that this family is an example of pseudodominant transmission. The combined pyrazinamide-probenecid test may cause a reduction in glomerular filtration rate and filtered load of urate and thereby affect urinary excretion rate of urate in patients with urate wasting.
Bloom's syndrome is one of the congenital disorders known to have increased frequency of acute leukaemia. The complex cytogenetic findings in the leukaemic cells of a 39-year-old male with Bloom's syndrome are described. These included a translocation t(7;17), missing 7q and 17p, a reciprocal translocation t(4;22); del 3q, del 8q22, del 20q, missing 12 and missing Y. In the same patient a missing Y had been noted 10 years previously in 15% of his peripheral blood lymphocytes.
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Nineteen patients treated continuously with Dipyridamole were evaluated for rectal bleeding. Thirteen suffered from overt rectal bleeding and six served as controls. Hemorrhoids were found in all patients. Contact bleeding was found in 16. The bleeding continued despite rubber band ligation, and stopped only on withdrawal of the drug.
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The case history of a 39-year-old man suffering from multiple myeloma is presented. During his illness he developed congestive cardiomyopathy, possibly due to amyloidosis, and a single perineal plasma cell infiltrate, resembling a perianal fistula. This diagnosis should be considered in patients with multiple myeloma suffering from perineal lesions.
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A patient with multiple myeloma in whom the bone marrow plasmablasts showed extensive lobulation is described. In addition to numerous lobes, some of the nuclei had a cerebriform appearance, similar to that observed in Sézary cells. The possible relation of this phenomenon to the expression of the altered function of the malignant cells is discussed.
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The ultrastructural alterations of the peripheral blood mononuclear cells of a patient with Reye's syndrome are reported. The involved cells were lymphocytes which showed marked nuclear changes such as irregular or highly convoluted nuclei, multilobulated nuclei, presence of scanty chromatin, and large nucleoli. Changes of the cytoplasmic organelles involved the mitochondria and dense bodies with well defined surrounding membrane appeared. The possibility that these findings indicate a viral etiology of the disease is discussed.
The effect of a single high dose of Levamisole (200 mg/M2) on delayed-type hypersensitivity (DTH) in vivo and on lymphocyte blastogenesis to mitogens and antigens in vitro was studied in 26 patients with carcinoma. Similar studies were conducted in 24 control patients. Levamisole had a moderate but significant enhancing effect on DTH to Dermatophytin detectable no earlier than eight hours and still present at 48 hours after the drug administration. A moderate but significant enhancing effect on lymphocyte blastogenesis to mitogens and antigens was also demonstrated during the same time sequence. Further clinical trials with Levamisole should be conducted with more attention paid to schedule of drug administration.